Nursing Report 2016

“Excellence is our starting point ... not our finish line.”

Executive Leadership2

Executive Leadership

John Warner, M.D., M.B.A.

Chief Executive OfficerUniversity Hospitals

Becky McCulley, M.S.N., RN

Chief Operations OfficerUniversity Hospitals

“The year 2016 was an important one for UT Southwestern nursing. In August, UT Southwestern

University Hospitals received Nursing Magnet® designation, the “gold standard” in nursing excel-

lence and the highest honor awarded by the American Nurse Credentialing Center. Our nursing

colleagues successfully led the lengthy, rigorous application process that required the teamwork

and involvement of doctors and staff at every level of our organization. This important milestone

supports our continued focus on the elevation of nursing at UT Southwestern and our commit-

ment to the highest standards of patient-centered care. We are very proud of our nurses – not

only for this remarkable achievement but also for their daily delivery of exceptional patient care.”

– John Warner, M.D., M.B.A.

Susan Hernandez, M.B.A., B.S.N., RN

Chief Nurse Executive UTSW Health System

3Executive Leadership

IntroductionHospital Executive Leadership Team

Message from the CNE

Nursing Philosophy, Mission, and Vision

Transformational LeadershipA Year of Nursing Excellence

Magnet Accreditation

Service Awards

D Magazine Excellence in Nursing

Advanced Practice Nurse Awards, Dallas-Fort Worth Great 100

DAISY Award

Nurse Excellence Awards, Strauss Award

Professional Recognition

Structural EmpowermentShared Governance

Surgical Specialty Unit 6-N

Certifications Executive Level, Hospital-Based Clinics, and Ambulatory Clinics

Clinical Education and Professional Practice

Opportunities for Advancement

Nurse Residency

Exemplary Professional Practice Best Nurses, Best Bedside Care

Nurse Satisfaction

Clinical Ladder, Outreach and Initiatives

Improvement in Neuro Care

Patient Satisfaction

Oncology Unit Quality Care

Wound Ostomy Team

Imaging Services

Outpatient Clinics

Advanced Practice Nurses

Connecting the Patient and Caregiver

Apheresis and Rapid Response

Ambulatory Services, Community Involvement

New Knowledge, Innovation, and ResearchNursing-Led Research

Presentations and Posters

In Memoriam

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On the cover: Leah Parker, B.S.N., RN

Managing Editor: Victoria England, M.B.A., B.S.N., RN, NE-BC Magnet Program Director

Editor: Ronnie Rittenberry

Design: Magdalena Zawojska-Smith

5Executive Leadership4 Executive Leadership

Reflecting on what a truly extraordinary year 2016 was for our teams at UT Southwestern, I want

to pause for a minute to express my profound gratitude for the work, energy, and dedication of

each and every nursing colleague here. Our collective successes throughout the year should be

recognized and celebrated.

We have remained true to our deep commitment to evidence-based practice in order to provide

the best care for our patients. Dedication to that commitment was reflected this year in a major

milestone for us: being formally designated a Magnet® institution. It is with great pride that we can

now say: We are Magnet®!

Message from the Chief Nurse Executive

Achievements

In addition to our Magnet® recognition, we also achieved several other benchmarks:

n We successfully implemented the “No More Moral Distress” (NoMMAD) consultative process, which was recognized by ANCC as a Magnet exemplar.

n In January, UTSW and our 12 South team were recognized for our commitment to elder care excellence with an international designation as an Nurses Improving Care for Healthsystem Elders (NICHE) site.

n Participation in nursing-led research at the bedside and evidence-based practice initiatives have grown by leaps and bounds, with 43 nurses leading research initiatives.

Our UTSW team has done terrific work to improve care for our patients, and the numbers bear that out. To cite just a handful of tangible improvements in our clinical quality, in 2016 we achieved:

n 59% reduction in Central Line Associated Bloodstream Infection (CLABSI) and Standardized Infection Ratio (SIR)

n 39% reduction in acute myocardial infarction readmissions

n 29% reduction in C Diff SIR

n 29% reduction in hip and knee surgery complications

n 18% reduction in post-op DVT/PE observed rate

Adaptation

Health care continues to transform rapidly. In order for UT Southwestern to be the best place to practice and provide care, we need to evolve as well. We will hold on to the great ideas and initiatives that have brought us here, but we also will continue to infuse our work with innovations and excellence as we move forward.

Our new partnership with Texas Health Resources, specifically with Texas Health Dallas (THD), is one example of our ability to advance with the industry. The launch of our patient experience work with THD is the kind of collaboration that will be a key to our success over the next several years.

Patient Experience

As busy as our clinicians are throughout each shift, they take the time to acknowledge the individual needs of every patient, and it shows, as is evidenced by the patient feedback we’ve received via notes and emails and have shared throughout the following pages, praising the work of the clinical team at UTSW.

Empowerment and Ownership

I have watched many of our nurses develop into successful leaders in their own right. As you continue to take ownership and empower others, it can only strengthen our work environment and professional practice.

As you’ll see in the pages that follow, 2016 was a truly magnetic year at UT Southwestern.

Excellence is our starting point ... not our finish line.

Susan Hernandez, M.B.A., B.S.N., RN

Chief Nurse Executive UTSW Health System

Executive Leadership 7Executive Leadership6

Our Commitment to Our Patients and Each Other

I will do my part to make the hospital environment a peaceful, quiet place dedicated to the healing of the

body and spirit.

I will anticipate the needs of patients and their families rather than waiting to be asked for assistance.

I will own and resolve every problem I can or personally hand over the problem to someone who can

resolve it.

I will respect the confidentiality of patients, their families, and my colleagues through discrete conversation

and attention to privacy.

I will be responsible for keeping our work environments clean and safe.

I will dress professionally, and I will speak and conduct myself in a manner that always keeps the focus

on our patients.

Nursing Philosophy

UT Southwestern is committed to providing quality nursing care through effective use of resources

and the development of innovative programs in clinical practice, education, and research.

We value the worth, dignity, and autonomy of our patients and their families. We believe that each

individual has unique physical, social, emotional, and spiritual needs that are served through

personalized, compassionate care.

We encourage each nurse to care for his or her body, mind, and spirit as a critical element in

achieving clinical excellence. Nurses at UT Southwestern are also encouraged to nurture and support

one another in an environment that fosters teamwork and interdisciplinary collaboration.

Working collaboratively affords us the opportunity for common goal-setting through trust, mutual

respect, and a commitment to open and honest communication in serving our patients.

UT Southwestern Nursing Mission and Vision

The Nursing Division at UT Southwestern is committed to being a national leader among academic

health centers in providing high-quality, safe, and innovative patient care and to being a model of

excellence in professional nursing practice, education, and research.

Bryan Leyster, B.S.N., RN

Transformational Leadership8 9Transformational Leadership

As health care continues on its path of rapid change, the Division of Nursing is leading

the charge with each step. Our journey supports the transformation needed to fulfill our

mission of excellence in patient-centered care. Every day, our world-class nursing teams

deliver comprehensive, quality care. They bring compassion and understanding to our

patients and loved ones, going beyond the routine to show genuine caring and making a

real difference in the process.

Nurse Executive Board Seated (left to right); Shelley Brown-Cleere, M.S.N., RN; Trish Jackson, M.S.N., RN, NE-BC; Lisa Dalton, M.B.A., B.S.N., RN, NE-BC, CRN;

Cheryl Kaplan, M.B.A., M.H.A., RN

Standing (left to right); Victoria England, M.B.A., B.S.N., RN, NE-BC; Deshonna Taylor, M.S.N., RN; Carolanne Capron-Reid, M.Ed., B.S.N., RN;

Rudy Arispe, B.S.N., RN; Amanda Truelove, M.S.N., RN, RNC-OB, NE-BC; Susan Hernandez, M.B.A., B.S.N., RN; Sherri Medina, M.S.N., RN;

Lori Hodge, D.N.P., RN, ONC, NEA-BC; Renee Bailey, M.S., B.S.N., RN, CNOR; Todd Bailey, M.S., B.S.N., RN, NE-BC;

Stephanie Huckaby, M.S.N., RN, RN-BC. Not pictured, Mike Mayo, M.S.N., RN, CCRN

Transformational LeadershipA Year of Nursing Excellence

“The circulating nurse was amazing.

She was in the procedure with me.

She made me feel more at ease

and comfortable. I didn’t feel like

a patient. She was there for the

entire procedure.”

Transformational Leadership 11Transformational Leadership10

Magnet Accreditation

Following an intense application process that lasted more than a year, UT Southwestern University

Hospitals and Hospital-based Clinics in August received designation as a Magnet Center for Nursing

Excellence® from the American Nurses Credentialing Center (ANCC). The designation is awarded to

only about 6.5 percent of hospitals across the U.S. and signifies that an organization’s nurses provide

excellent, evidence-based patient care, advance their practice through research and professional

development, and are recognized and respected by their colleagues for the important role they play on

the patient care team. It’s the highest honor a hospital can receive for its Division of Nursing.

At a celebration following the

announcement, UTSW Chief

Nurse Executive Susan

Hernandez, M.B.A., B.S.N., RN,

said, “Thank you to everybody we have

worked with on this journey. This is you. This

is your work. We did it together as a team.”

John Warner, M.D., M.B.A., University Hos-

pitals CEO, also expressed thanks to all the

nursing teams involved. “I’m proud of us,”

he said, “but I’m more proud of what we’re

about, which is taking care of patients and

their families.

“When I took this job almost five years ago,

we had a list of goals, and this was on it. But

beyond this was to be the very best hospital in

Dallas, which I think we are. We want to be the

best in Texas, which I think we’re well on our

way to being, and eventually want to be the

best, period. And nursing is the cornerstone of

that. This is an important achievement, and

we’re going to have a lot of fun celebrating

this, but let’s remember: This is the starting

line, not the finish line.”

In early October, 44 University Hospitals

employees represented UT Southwestern at

the ANCC’s National Magnet® Conference in

Orlando, Florida. The group made the jour-

ney to formally accept and further celebrate

UTSW’s Magnet accreditation. The event

was abbreviated by the presence of Hurri-

cane Matthew, which also chose that week to

journey to Florida.

Kelli Holzwarth, B.S.N., RN, said attending

the conference was nevertheless a bless-

ing. “Not only did we hear from inspirational

world-changers who light a fire within your

soul,” she said, “but we made new friends

and new connections and met many new

role models and new references. Yes, the

Magnet conference was cut short, but I

wouldn’t trade it for anything – dance parties,

tears of joy, blinking hats, glow sticks, high-

fives all around, roller coasters, hurricanes,

and all. It was awesome.”

From left: Amber Ulate, M.S.N., M.H.A., RN, John Warner, M.D., M.B.A., and Victoria England, M.B.A., B.S.N., RN, NE-BC

The Meritorious Service Award is bestowed

annually to hospital and clinic employees

who have provided extraordinary service and

care to our patients and demonstrated an

excellent work ethic and performance. These

UT Southwestern employees exemplify PACT

standards (Problem-Solving; Ability, Attitude,

and Accountability; Communications and

Compassion; and Teamwork) and serve

as role models to the campus. The PACT

program was designed by the staff to set

expectations for interactions with each other

and with patients. The 2016 recipients were:

Tomas Armendariz, B.S.N., RN,

CMSRN – Apheresis

Chelsea Bracher, B.S.N., RN – 11 North

Amanda Branson, B.S.N., RN –

Neuroscience ICU

Sachithanandam Devadoss, B.S.N.,

RN – 9 North

Crystal Engle, A.D.N., RN – 7 North

Sara Fay, B.S.N., RN – 6 South

Matthew Flury, B.S.N., RN, CPAN –

Day Surgery

Amabelle Garciano, RN – 12 South

Heath Hampton, B.S.N., RN, CRN –

Imaging Services

Abigail Jaeger, B.S.N., RN – 10 South

Donna Jueckstock, B.S.N., RN –

5 North NICU

Wen-Chi Kung, RN – Zale Surgery

Ruqi Lai, B.S.N., RN – 6S/N

Blair Lane, B.S.N., A.D.N., RN, CCRN –

8 South MICU

Keitha Massingill, B.S.N., RN – CUH Surgery

Taylor Mayberry, B.S.N., RN – 5th Floor Zale

Christie Nichols, B.S.N., RN, BMTCN –

Simmons Cancer Center Infusion MCI

Fort Worth

Nancy Palacios, B.S.N., RN – 7 Zale

Surgical Specialty

David Rogers, B.S.N., RN –

Emergency Department

Mary Russell, RN – 9 South CVICU

Ayisatu Salami, RN – Rapid Diagnostic Unit

Brooke Shadday, B.S.N., RNC-OB –

5 South Delivery Room

Kathrina Siaron, RN – Acute Stroke Unit

Jaimol Sreedharan, B.S.N., RN, CCRN –

8 North

Terri Thompson, B.S.N., RN –

Presurgery Assessment

Superior Customer Service Award:

The Superior Customer Service Award is given

to clinics that receive a Press Ganey percentile

ranking of at least 95 percent in two out of

three areas during a quarter. Rankings cover

the areas of Overall Access, Moving Through

Your Visit, and Overall Care Provider.

The Adult Cystic Fibrosis Clinic earned the

Superior Customer Service Award in 2016.

Meritorious Customer Service Award:

The Meritorious Customer Service Award is

presented to clinics that receive a Press Ganey

score of at least 95 percent in all three areas

(Overall Access, Moving Through Your Visit,

and Overall Care Provider) during a quarter.

The Kidney/Liver Clinic earned the Merito-

rious Customer Service Award in 2016.

Meritorious Service Award 2016

From left: Nancy Palacios, B.S.N., RN, Kourtney Fontenault, B.S.N., RN, TNCC, Sarah McCraw, B.S.N., RN, at the ANCC National Magnet Conference in Orlando.

Transformational Leadership 13Transformational Leadership12

Each year, D Magazine honors excellence

in nursing through an award recognizing

nurses who have made a difference in the

lives of their patients and colleagues. These

nurses are nominated by their peers,

co-workers, and patients.

Through a selection committee, 73 winners

were recognized in 20 categories.

UT Southwestern is proud to salute 11 recip-

ients of the 2016 D Magazine Excellence in

Nursing Awards.

1. Jaspreet Abraham, M.S.C.S., B.S.N., RN

Ambulatory

2. Cathleen Bauer, M.S., RN, ANP-C

Advanced Practice

3. Sherry Clark, M.S., B.S.N., RN

Sub-Acute Settings

4. Thomas Cutler, M.B.A., RN, FACHE

Research Informatics

5. Laura Duran, M.S.N., RN-BC, CNRN

Nurse Manager

6. Dara Mariani, B.S.N., RN, CCRN

Caring for Patients in Hospitals

7. Claudia Quittner, M.S.N., B.S.N., RN

Nurse Research

8. Kim Siniscalchi, M.S.N., RN, FAAN,

Major General (RET. USAF, NC)

Leadership

9. Carolyn Swann, M.B.A., RN

Leadership

10. June Taylor, RN, CWS

Ambulatory Clinic Nurse

11. Deborah Walker, B.S.N., RN, OCN

Oncology Nurse

D Magazine Excellence in Nursing Awards Advanced Practice Nurse Awards

Advanced Practice Nurses at UT Southwest-

ern share their skills and training in many ways,

both on and off campus, and they’re often

recognized for their efforts. In 2016, the follow-

ing four individuals received unique kudos.

Genice Nelson, ANP-BC, received the

Sojourner Truth Award from the Southern

Connecticut chapter of the Sickle Cell Dis-

ease Association of America.

Tony Garcia, AGACNP-BC, received a

scholarship from the American Association

of Critical Care Nurses’ End-of-Life Nursing

Education Consortium in Tulsa, Oklahoma.

Dallas-Fort Worth Great 100 Nurses

Leticia Khosama, ANP-BC, was UT South-

western Medical Center’s APRN of the Year.

Kimberly George, ACNS-BC, was twice

honored; she was named a Multiyear Tier 1

Leader by Press Ganey and received the

Previous National Oncology Certified Nurse

of the Year Award from the Oncology Nursing

Certification Corp./Oncology Nursing Society.

Dallas-Fort Worth Great 100 recognizes 100

professional Registered Nurses each year

who have been nominated by their peers,

practice sites, families, and patients entrusted

to their care. Each year, Great 100 honors

excellence in the art and science of nursing

across all practice areas, including acute

care, sub-acute care, school nursing, nurse

leaders, academics, and many more.

UT Southwestern is honored to have four

nurses receive this award in 2016.

DFW Great 100 recipients (left to right):

Stephanie Huckaby, M.S.N., RN, NEA-BC, CSSGB;

Mike Mayo, M.S.N., RN, CCRN; Gloria Menard, M.S.N., RN;

Deborah Spitzer, M.S.N., RN, OCN

1 2 3 4

4 5 6

7 8 9

10 11

“The nursing team was very prompt, very well-informed, very caring, and, above all, compassionate.”

Transformational Leadership 15Transformational Leadership14

To recognize our amazing nurses in direct

patient care, UTSW has partnered with the

DAISY Foundation, which established the

DAISY (Diseases Attacking the Immune

System) Award in memory of J. Patrick

Barnes, who died at age 33 of ITP, an auto-

immune disease. After witnessing the skilled,

caring, and compassionate nursing Patrick

received, the Barnes Family created this

national award as a way to say “thank you”

to nurses everywhere. Any nurse can be

nominated for the DAISY Award. The award

committee selects one nurse each month

from a hospital or hospital-based clinic who

exemplifies our mission. Each month’s win-

ner receives a nominee pin, a DAISY Award

recipient pin, a Healer’s Touch hand-carved

statue, and an award certificate. In addition,

the selected nurse’s unit receives a banner

to post for the month and freshly baked

DAISY Award

1 2

3 4

5 6

cinnamon rolls for everyone on the day the

award is presented. DAISY honorees from

UT Southwestern for 2016 were:

1. Candice Coker, B.S.N., RN – 8 South CUH

2. Kathleen Collett, A.D., RN – Zale Lipshy OR

3. Sarah Mertz, B.S.N., RN – Emergency

Department CUH

4. Tanya Persoon, B.S.N., RN – 11 South CUH

5. Rocky Sonemangkhara, B.S.N., RN,

CCRN – 8 South CUH

6. Brenda Alfred-Taylor, RN – Zale Lipshy

Psychiatry

The quarterly Strauss Award recognizes

employees who exemplify excellent care and

service in a professional and positive manner,

dedication to teamwork, and compassion for

patients, guests, and co-workers. Employees

from both Clements University Hospital and

Zale Lipshy University Hospital are recognized.

Honorees in 2016 were:

1. Noel Beboso, B.S.N., RN, CCRN,

7 South SICU, Clements University Hospital

Direct Patient Care

2. Sara Graff, B.S.N., RN, 9 North Cardiology,

Clements University Hospital

Direct Patient Care

Strauss Award

3. Leslie Green, M.S., B.S.N., RN,

Float Pool, Clements University Hospital

Direct Patient Care

4. Nisha Jones, B.S.N., RN, Performance

Improvement Hospital Quality

5. Cynthia Moore, B.S.N., RN, CCM,

Inpatient Rehabilitation,

Zale Lipshy Hospital Intake Coordinator

6. James West, B.S.N., RN, Apheresis,

Zale Lipshy University Hospital

Direct Patient Care

1 2

3 4

5 6

1 2 3

4 5 6

During Nurses Week in May 2016, UTSW

bestowed its first Nurse Excellence Awards.

In all, more than 45 potential recipients were

nominated by their peers for exemplifying

what it is to be a role model, a leader, a

compassionate caregiver, and a significant

contributor who works to improve the com-

munity, organization, and patient outcomes

through effective listening, inspiring others,

actively participating in the community, and

devotion and compassion in caring for pa-

tients and their families. The six winners of the

inaugural Nurse Excellence Awards were:

1. Jenna Hunter, B.S.N., RN –

Zale Lipshy Hospital Surgery

Direct Care Zale

2. Amy Johnson, B.S.N., RN – Clements

University Hospital 10 North Manager

Leadership

UTSW Nurse Excellence Awards

3. Leticia Khosama, APRN – Simmons

Comprehensive Cancer Center

Advanced Practice Nurse

4. Cary Orrick, M.S.N., RN, CCRNEDU –

Clements University Hospital

Emergency Department

Educator

5. Merary Plata, B.S.N., RN – Clements

University Hospital 10 North

Direct Care CUH

6. Fatemeh Youssefi, B.S.N., RN, OCN –

Infusion Clinic

Ambulatory

June 2016 Zale Lipshy Hospital, Surgical Services Daisy Winner: Kathleen Collett, A.D., RN (holding certificate)

October 2016 Clements University Hospital, 11 South Daisy Winner: Tanya Persoon, B.S.N., RN (holding certificate)

Transformational Leadership 17Transformational Leadership16

Nursing along with staff in UT Southwestern’s

Kidney/Liver Program, who work together to

care for patients as they transition in and out

of William P. Clements Jr. University Hospi-

tal and into the UTSW Kidney/Liver Clinic,

were collectively selected for the Institute for

Innovation® Case Study in Teamwork. The

team, which provides care for patients with

advanced chronic kidney disease and end-

stage renal and liver failure, as well as those

undergoing or awaiting kidney transplant, liver

transplant, and/or hepatobiliary surgery, was

honored for its “high levels of performance

when delivering patient-centered care.”

Professional Recognition

Kidney/Liver Transplant Program Selected for Institute for Innovation® Case Study in Teamwork

Press Ganey is a national consulting firm

specializing in health care performance. Its

nonprofit collaborative research division,

called the Institute for Innovation®, so admired

the UTSW application that it transformed the

team’s work into a case study that readers

can download to learn best practices related

to the issues they face.

UT Southwestern Harold C. Simmons Com-

prehensive Cancer Center (SCCC) received

recognition in 2016 by the QOPI Certification

Program (QCP™), an affiliate of the Amer-

ican Society of Clinical Oncology (ASCO),

after successfully completing a three-year

certification program for outpatient hematol-

ogy-oncology practices that meet nationally

recognized standards for quality cancer care.

QCP builds on ASCO’s Quality Oncology

Practice Initiative (QOPI®).

In applying for certification, SCCC participat-

ed in a voluntary comprehensive site assess-

ment against clearly specified standards that

are consistent with national guidelines. SCCC

was successful in meeting QCP’s standards

and objectives.

Achieving the QOPI certification was a jour-

ney involving multidisciplinary team members,

including the nursing leaders within SCCC.

Hematology Oncology Nursing Supervisor

Mary Gill, B.S.N., RN, OCN, and Infusion

Room Nursing Supervisor Tobi Duncan,

B.S.N., RN, OCN, led the efforts to ensure

that the QOPI core standards in the areas of

patient education and consent, safe chemo-

therapy administration, and monitoring and

assessment of patient well-being were met

and consistent across each practice site in

Dallas and Richardson and at Moncrief.

“ASCO’s QOPI certification recognizes those

oncology practices that are committed to

delivering the highest quality of cancer care,”

said ASCO President Daniel F. Hayes, M.D.,

FASCO. “By achieving certification, these

practices have demonstrated their commit-

ment to quality and safety excellence in the

care they deliver to patients, as well as to the

continuous process of quality improvement.”

SCCC Earns ASCO Certification for Highest-Quality Cancer Care

Autumn Webb, M.B.A., B.S.N., RN, CCRN (left), and Raechelle Robertson, B.S.N., RN

Structural Empowerment 19Structural Empowerment18

Structural Empowerment The shared governance model at UT Southwestern Medical Center is an organizational

structure in which clinical nurses have a voice in determining nursing practice, standards,

and quality of care.

Our Shared Governance Council structure is built on the foundation of teams coming

together to create and implement actions that result in quality patient outcomes. Nurses

from all areas expand their awareness, broaden their knowledge, and enhance their ability

to make the best decisions for our patients and their families. Over 685 direct care nurses

and clinical staff participate in shared decision making through unit-based councils, commit-

tees, and the UT Southwestern Hospital and Hospital-Based Clinics Council structure.

This approach fosters an atmosphere of teamwork and professionalism and empowers every

nurse to take ownership and pride in their work and to have a voice in their nursing units.

UTSW Shared Governance Structure

UTSW has a strong shared governance structure that includes all staff from all areas

and disciplines, as reflected in the following examples.

“It’s a great staff on 7th Floor North. They were all very professional and showed care and interest in me at all times; they took care of my husband who stayed with me, too.”

Structural Empowerment 21Structural Empowerment20

6North is a 48-bed surgical special-

ty unit within Clements University

Hospital serving primarily Urology

Surgery and Plastic Surgery. The

6N nursing staff has become expert in both

of these patient populations. In the first

three quarters of 2015, the unit’s patients’

perception of pain measured through the

Hospital Consumer Assessment of Health-

care Providers and Systems (HCAHPS)

index ranged from the 30th-50th percen-

tile ranking. Knowing pain control is very

important to patients, particularly to the 6N

patient population, the unit identified this as

an opportunity for improvement. Through

the work of a unit-based council (UBC) and

department leaders, pain became the

priority for the department, and an action

plan was implemented.

Plan implementers hardwired a pain assess-

ment into nurses’ bedside report and hourly

rounding, making sure staff addressed

pain during every hand-off. Dry erase

boards were used in each patient’s room

to communicate with the patient and family

when the next pain med would be available.

During leadership rounds, patients were

asked the following questions:

“How are we doing in controlling your pain?”

“Do you know when you can have your next

pain medicine?”

The unit’s goal was to be at the 90th

percentile or above on HCAHPS, signifying

improved pain control for its patients. As the

graph below shows, the unit has met this

goal for the past four quarters.

Shared Governance in Action at Clements University Hospital Inpatient Unit

Certifications

UT Southwestern nurses validate their mas-

tery of skills, knowledge, and abilities through

certification and meet ongoing learning and

practice requirements through recertification.

Patients and families benefit from certifica-

tion because it assures them that the nurse

caring for them has demonstrated experi-

ence, knowledge, and skill in the complex

specialty of their care. Nurse certification and

the continuing education required to maintain

certification contribute to the creation of an

environment of professionalism and a culture

of retention. Certification also differentiates

UT Southwestern from other health care

organizations, demonstrating to consumers

that we have attracted the most skilled and

experienced nursing professionals.

In 2016, the Nurse Executive Board (NEB)

outperformed its goal of increasing specialty

certifications by 5 percent each year, as

demonstrated below at right.

UTSW Hosts Inaugural Transplant

Coordinator Review Course

The UT Southwestern Solid Organ Transplant

program hosted the North American Trans-

plant Coordinators Organization (NATCO) on

March 3-4, 2016, for the first regional Certified

Clinical Transplant Coordinator (CCTC) review

course. In all, 58 transplant coordinators from

18 states and one from Ontario, Canada,

attended the event. The CCTC review course

is designed to provide the information and

confidence that potential candidates need to

pass the examination the first time. Candidates

must complete 12 months of clinical vascular

organ work experience.

Ambulatory Nurses Hone

Clinical Expertise

Quarterly every year, UT Southwestern offers

an on-site opportunity for ambulatory nurses

who are interested in becoming board

certified in the discipline to take part in an

American Academy of Ambulatory Care

Nursing (AAACN) certification review course

and leadership training. The two-day course

includes 8 hours of certification review mate-

rial along with leadership sessions delivered

by the UTSW Department of Organiza-

tional Development & Training. In 2016, 26

UT Southwestern RNs participated in the

course; their pass rate for the examination

was 100 percent.

UT Southwestern Specialty Certified Nurses 2015-2016

1200

1000

800

600

400

200

02015 2016

677 728

Annette Forbes, B.S.N., RN

6 North Pain Well Controlled - pulled by discharge date Lg PG DB

120%

100%

80%

60%

40%

20%

0%QTR 1/2015 QTR 2/2015 QTR 3/2015 QTR 4/2015 QTR 1/2016 QTR 2/2016 QTR 3/2016

Press Ganey database benchmark

99%99%99%

90%

37%

49%54%

Structural Empowerment 23Structural Empowerment22

90%

85%

80%

75%

70%

65%

60%

55%

50%

45%

40% 2010 2011 2012 2013 2014 2015 2016

58% 57.4% 59% 66.2% 77.5% 78% 79%

Percentage of Direct Care RNs with B.S.N. Degrees and Higher

% o

f RN

s B

.S.N

. pre

par

ed

% of RNs with B.S.N. and above

New Programs to CEPP

Starting in July 2016, new nursing graduates

enter practice through UT Southwestern’s

Nurse Residency Program. Over the course

of a year, the nurse residents are offered

didactic instruction and provided with clinical

rotations, a preceptorship, and monthly

workshops. These team-based learning

experiences are designed to enhance clinical

skills and critical decision-making. Mentoring

occurs during the latter part of the program

to evaluate clinical progress, acclimation to

the environment, and identification of ongoing

personal and professional development

needs. The retention remains at 100 percent

since the program’s inception.

Leadership Team

Trish Jackson, M.B.A., M.S.N., RN, NE-BC

Sue Ruffner, B.S.N., RN

Tracy McGaw, M.S.N., RN, CCRN, CNRN

Support Team

Joyce Maples, M.S., B.S.N., RN

Guadalupe Quintanilla, B.S.

Jean Hoyt-Sehnert, M.S., B.S.N., RN, NEA-BC

Jessica McNeil, M.S.N., RNC-OB

Education Coordinators

Arlanda Redman, B.S.B.A.

Paula Dunn

Naudia Moore, M.B.A., B.A.A.S., CMA

Clinical Educators/Professional Development Specialist

Alfonzo Mendoza III, B.S.N., RN, CCRN-CMC, CNRN

Allen Kirby, M.B.A., B.S.N., RN

Barbara Crim, M.B.A., RN, CNOR

Deborah Spitzer, M.S.N., RN, OCN

Elsa John, B.S.N., RN

Gwen Way, M.S.N., RN-BC

Hazzel Gomez, M.S.N., RN

Kelli Hulsman, M.S., B.S.N., RN, IBCLC

LaBecca Doyle, M.A., B.S.N., RN

Liffy Cherian, M.S.N., RN, OCN

Kathie Waldron, M.S.N., RNC-NIC

Marilynn Bordelon, M.S., RN, CMSRN

Shannon Bowling, D.P.T., PT

Sheena Mathew, M.S.N., RN, CPN

Tarin Prince, B.S.N., RN

Career Assessment and Transition Program

In conjunction with Human Resources and

the Organizational Development & Train-

ing Departments, CEPP has developed

a Career Assessment & Transition (CAT)

program. The program focuses on experi-

enced nursing staff who transition from one

unit to another. The structure allows clinical

staff to explore career opportunities within

UTSW; provides staff with personalized

career counseling to define career goals

and objectives; and delivers post-transition

support through specialty-specific curricu-

lum and individualized mentoring. Since the

launch, 18 applicants have gone through

the program.

Clinical Orientation:

549 Licensed Staff

609 Non-Licensed Staff

Continuing Education:

Contact Hour Programs Offered 163

Contact Hours Provided 707

Contact Hours Participants 4,300

Clinical Placement

95 High School Students 10,201 Hours

309 Undergraduate Students 29,802 Hours

367 Graduate Students 10,740 Hours

Educational Levels

In October 2010, the Institute of Medi-

cine released its landmark report on “The

Future of Nursing,” initiated by the Robert

Wood Johnson Foundation, which called

for an increase in the number of baccalau-

reate-prepared nurses in the workforce to

80 percent by 2020. The expert committee

charged with preparing the evidence-based

recommendations in this report stated that

to respond “to the demands of an evolving

health care system and meet the changing

needs of patients, nurses must achieve

higher levels of education.”

The UTSW Nursing Executive Board is

ultimately responsible for attaining this 80

percent B.S.N. goal. As illustrated in the

graph at right, we have come increasingly

close to achieving this objective.

Department of Clinical Education

& Professional Practice (CEPP)

Outcomes for 2016

The Department of Clinical Education &

Professional Practice (CEPP) provides sup-

port for nurses by offering education, train-

ing, and professional development activities.

This includes clinical orientation, clinical

placement, and education on standards

of care and quality improvement. CEPP is

committed to achieving and maintaining

excellence and advancing the practice of

clinical staff.

Outcomes for this area included:

“The nurse said, ‘I promise to keep you safe,’ and that was important to me.”

Emergency Management Certifications

693 ACLS Participants

9596 AHA RQI Participants

1049 BLS Participants

78 Neonatal Resuscitation Participants

156 PALS Participants

140

120

100

80

60

40

20

0Attendance Total

Nurse Residency Mixer

130

87

February 3, 2016 September 7, 2016

2524 Structural EmpowermentStructural Empowerment

UT Southwestern Medical Center encourages, values, and recognizes continuing education

and certification as integral to the professional development of our nurses. Our roadmap for the

future of nursing includes strategic goals and provides nurses with an environment that fosters

excellence through continual learning and the development of transformational leaders.

Shared decision-making and accountability empower nurses who care directly for patients,

and UTSW’s new nurse residency program offers a framework for creating improvements to

promote safety, innovation, and excellence.

Amanda Reitz, B.S.N., RN, PCCN (left), and Moriah Lyons, B.S.N., RN (right), welcome a Nurse Residency Mixer attendee (center).

Opportunities for professional advancement are a valued part of our commitment to quality care and the education of future nurses.

Shared decision-making and accountability

empower nurses who care directly for pa-

tients with a process for creating improve-

ments to promote safety, innovation, and

excellence. Opportunities for professional

advancement are a valued part of our com-

mitment to quality care and the education

of future nursing leaders.

UT Southwestern Medical Center has a

commitment to professional development

and offers nursing education opportunities

for those interested in a nursing career.

Good examples of such opportunities were

the two Nurse Residency Mixers the Depart-

ment of Clinical Education and Professional

Practice hosted in 2016.

The Department’s goal was to increase interest

in and visibility of UTSW’s Nurse Residency

Program by inviting potential RN graduates

from Texas and surrounding areas to come

to campus and meet current staff members

and learn what our program has to offer.

Together, the two mixers attracted 217 par-

ticipants from 23 Texas schools of nursing

and one Tennessee school of nursing.

Kelly Murphy, B.S.N., RN, helps potential RN graduates learn about UTSW’s Nurse Residency Program.

Nurse Residency

200

180

160

140

120

100

80

60

40

20

0

Nurse Residency Recruitment Efforts

Applicants Interviews Hired

July 2016 February 2017

3249

120107

170163

Exemplary Professional Practice 27Exemplary Professional Practice26

Exemplary Professional PracticeBest Nurses, Best Bedside Care

The 7 South Surgical Intensive

Care Unit at William P. Clements

Jr. University Hospital is a 24-bed

ICU that cares for critically ill surgical

patients. Patient care is dependent upon acuity

but is often 1:2 nursing care, with higher-acuity

patients receiving 1:1 or 2:1 care at times. The

SICU’s nurses, 81 percent of whom hold a

B.S.N. and 54 percent of whom are certified,

pride themselves on providing innovative care

and incorporating evidence-based practices

as part of their successful outcomes. Striving

to maintain a welcoming, empowering,

engaging, and safe environment, the SICU has

yielded commendable patient and employee

satisfaction scores. Since its inception, the

unit has had no cases of central line-associ-

ated blood stream infections (CLABSIs) or

ventilator-associated pneumonia. Consistent

education, real-time accountability, and a

culture that fosters change, compliance, and

quality have generated two years without

either of these hospital-acquired infections.

The 7 North Surgical/Transplant Unit in

Clements University Hospital is a 32-bed unit

serving multiple patient populations. The unit’s

nurses are specially trained in the care of

immunocompromised patients and experts in

the care of kidney and liver transplant patients.

Recently, the Kidney/Liver team held a sym-

posium to update the education of the unit’s

nurses, who also are instrumental in maintain-

ing 7 North’s bariatric accreditation.

Of the unit’s 39 RNs, 34 (88 percent) have

earned their B.S.N., two hold M.S.N.

degrees, and four are currently enrolled in

master’s degree programs.

Based on a collaborative process improve-

ment plan implemented in 2016, kidney

transplant patients were admitted directly to

the acute care unit after an appropriate stay in

the Post-Surgical Recovery Unit, rather than

being admitted to the Surgical Intensive Care

Unit (SICU), based on clinical indications.

Prior to that time, regardless of necessity, all

patients were admitted to the SICU. This new

process has improved the patient experience

and decreased their length of stay.

4 4 4 45 5

6

SICU to 7N

patient

1

patient

3

patient

4

patient

5

patient

6

patient

12

patient

13

Total Midnight Stays – SICU to 7N vs PACU to 7N

n = 7; mean = 4.571; median = 4

PACU to 7N

patien

t 2

patien

t 7

patien

t 8

patien

t 9

patien

t 10

patien

t 11

patien

t 14

patien

t 15

patien

t 16

patien

t 17

43 3 3 3 3 3

9

7 7

n = 10; mean = 4.5; median = 3

Num

ber

of

Mid

nig

ht S

tays

Num

ber

of

Mid

nig

ht S

tays

“I appreciate our nurses’ overall

professionalism. They were all

excellent. They displayed organized

teamwork. I didn’t have to wait

long for discharge papers.”

Exemplary Professional Practice 29Exemplary Professional Practice28

Clinical Ladder

UTSW’s Clinical Ladder process promotes

clinical growth and development, addresses

recruitment and retention, and encourages

and rewards nurses in direct patient care and

non-administrative roles.

“Recognition, reward, and retention of the

experienced nurse in positions of direct clin-

ical practice – along with the documentation

and adequate description of their practice

– are the first steps in improving the quality

of patient care.” (Patricia Benner, M.S., RN,

“From Novice to Expert,” The American

Journal of Nursing, 82(3), 1982, p. 407.)

The UTSW Clinical Ladder is open to all

clinical nurses involved in direct patient care.

Outreach and Initiatives

Collaborative Effort Reduces ‘LOS’

Numbers So Patients Win

A good example of UTSW’s commitment

to quality patient care and education is the

“Joint Class” created in 2016, designed for

and open to any patient coming to UTSW

for an elective total joint replacement of the

knee or hip. A collaborative effort of the

departments of Nursing, Inpatient Therapy

Services, Physical Medicine and Rehabilita-

tion, and Orthopaedic Surgery, along with

Therapy Services and the Outpatient Ortho-

paedics Clinic, the goal of the class was to

better prepare patients for their surgery and,

ultimately, to increase patient satisfaction. It

was hoped that, by August 2016, the class

also would lead to a decrease in patients’

length of stay (LOS) by 25 percent.

The idea for the course originated in October

2015, when Kenneth Estrera, M.D., Assis-

tant Professor of Orthopaedic Surgery, and

the Inpatient Orthopaedic Nursing Manager

attended a bundle payment workshop. In

January 2016, the Outpatient Physical Med-

icine and Rehabilitation Department created

a “Prehab” program, focused on prehabili-

tative practices for patients planning to have

knee or hip joint replacement surgery. In

March 2016, representatives from Nursing

Services, Therapy Services, and the Depart-

ment of Physical Medicine and Rehabilita-

tion attended a class on Clinical Safety and

Effectiveness. Collective insights from these

ventures were pooled, and in June 2016

the first “Joint Class” was formed, meeting

every first and third Tuesday each month.

By the end of 2016, thanks in part to the

effectiveness of this class, UTSW patients’

LOS after a joint replacement had decreased

from 4.3 days in the hospital to 3.4 days.

Clinical Ladder Recipients 2016

Ambulatory Clinical Ladder Recipients 2016

Level One

Level Two

Level Three

Level Four

Level One

Level Two

Level Three

Level Four

%

%

20

13

4324

14

14 31

41

Nurse Satisfaction Survey

Each year, UT Southwestern participates in

a nationally benchmarked nurse satisfaction

survey. Literature shows that when nurses

enjoy their jobs and intend to stay in their

positions long term, it translates to improved

patient outcomes. Due in part to the many

programs in place at UTSW to support

clinical nurses as they provide quality patient

care, the UTSW Division of Nursing outper-

forms other academic medical centers in

all areas of nurse satisfaction, as the graph

below shows.

Tammie Robinson, RN, OCN, left, and Rosemarie Espinoza B.S.N., RN, OCN, share a moment.

6.00

5.00

4.00

3.00

2.00

1.00

0

Autonomy Professional Development Opportunity

Manager Leadership

Nurse-Nurse Interactions

Interprofessional Relationships

Nursing Foundations for Quality

of Care

Staffing and Resource Adequacy

4.61

4.38

4.74

4.44

3.12

3.03

5.12

5.11

3.91

3.82

3.19

3.06

UTSW Mean

NDNQI Academic Medical Centers Mean

2.89

2.69

Mea

n R

N S

atis

fact

ion

UTSW 2016 RN Satisfaction vs NDNQI Academic Medical Centers

Exemplary Professional Practice 31Exemplary Professional Practice30

Neuro ICU Achieves Extreme

Improvement in t-PA Charting for 2016

In January 2016, UT Southwestern’s Zale

Lipshy University Hospital was up for

recertification for The Joint Commission’s

Comprehensive Stroke Certification. One

of the areas noted for improvement from

2015 was in compliance of t-PA monitoring

documentation, specifically in the hospital’s

Neuroscience Intensive Care Unit (NSICU),

a 20-bed unit serving primarily stroke and

neurosurgical patients.

Led by Suzanne Stone, B.S.N., RN, the

NSICU team took action to ensure the

necessary improvement.

First, the team created a t-PA documentation

checklist to be used for real-time auditing.

Next, team leaders re-educated staff on t-PA

charting expectations. And finally, leaders

created a “double check” system of docu-

mentation between oncoming and off-going

charge RNs. The goal of such measures

100%

90%

80%

70%

60%

50%

40%

30%

20%

10%

0%

NSICU Compliance with t-PA Documentation

QTR 2/2015 QTR 3/2015 QTR 4/2015 QTR 1/2016 QTR 2/2016 QTR 3/2016 Nov. 2016

7%

31%

63%71%

62%

100%

81%

QTR 1/2015

0%

Pre-initiatives Post-initiatives

Patient Satisfaction Initiative Yields

Positive Results

A unit-based council (UBC) from the De-

partment of Psychiatry worked with nursing

leadership throughout the year to improve pa-

tient satisfaction, to include patients and their

families in treatment planning, to promote

recovery from mental illness, and to improve

staff engagement. Accomplishing these

goals, the UBC believed, would improve pa-

tient outcomes in medication compliance and

reduction in readmissions and support the

American Psychiatric Nurses Association’s

(APNA’s) “Recovery to Practice” initiative,

which is included in the Department’s Psychi-

atric Nurse Scope and Standards of Practice.

The UBC and nurse leaders implemented a

“team conference” to be held within 48 hours

of each patient’s admission. This is a multidis-

ciplinary meeting with each patient and his/

her family (if the patient consents) to discuss

the diagnosis and treatment plan from a

multidisciplinary perspective. The meeting’s

theme is that the patient and family are part of

the planning and their input is vital. This allows

for better communication, a team atmosphere,

and for patients and families to be involved

and engaged in the recovery process. The

Department firmly believes in the importance

of including families in care planning because

support is the No. 1 predictor of good

recovery in psych patients.

In May 2016, the UBC implemented the

APNA “Recovery to Practice” curriculum

in a class open to all psychiatric staff. This

curriculum focuses on knowledge, com-

munication, attitudes, and interventions for

patients with trauma and mental illness. It

is a patient-centered approach promoting

recovery and trauma-based care principles.

All staff attended the eight-hour class

(including physicians) between May and

the present. The class was also part of a

statewide Institutional Review Board study to

measure recovery knowledge pre- and post-

class. Data are submitted from each class

and a report is generated with demographics

for each participating organization. Classes

are ongoing, offered every other month and

open to all hospital staff on a voluntary basis.

As an indicator of this initiative’s success, the

Department had hoped to achieve scores

of 90 percent (“very good”) or higher on the

patient satisfaction survey by September 1,

2016. As shown in the graph above, which

details the questions asked of patients to

reach the overall patient satisfaction score,

the Department’s hopes were realized.

Patient Satisfaction

You were included in decisions about your care.

Overall, how would you rate the care given at this hospital?

Opportunities were given to include your family/support in your care.

Likelihood of your recommending this hospital to others.

100

50

01-Dec 1-Jan 1-Feb 1-Mar 1-Apr 1-May 1-Jun 1-Jul 1-Aug 1-Sep 1-Oct 1-Nov

Charlotte “Gaile” Hall, B.S.N., RN, psychiatric nurse at Zale Lipshy

“My nurses were absolutely

amazing. The entire staff was

hands-down the best!”

was always to ensure the NSICU’s stroke

population was receiving the best quality care

in regards to t-PA administration and to make

sure documentation reflected that care.

Putting those measures in action met with

great success for the year. As reflected in

the bar graph above, for November 2016

the team achieved 100 percent for t-PA

compliance charting, making the overall

achievement for the year 80 percent.

Exemplary Professional Practice 33Exemplary Professional Practice32

11 South is an adult stem cell transplant,

bone marrow transplant, and oncology unit

serving patients diagnosed with hematologic

malignancies. In 2016, the unit’s nursing team

was faced with the challenge of a severely

increased CLABSI rate, but team members

proved their adaptability by successfully

implementing an action plan that was able to

stabilize numbers.

Due to the nature of the cancers the unit

treats and the high-dose chemotherapy its

nurses administer, the majority of 11 South

patients have a central line and spend several

days severely neutropenic. Not only does a

central line-associated blood stream infection

greatly increase the cost to the hospital, it can

cost the patient even more and can easily be

the difference between life and death in the

unit’s immunocompromised world. Because

of the increased risk posed to patients, infec-

tion control and central line care have always

had an urgent importance to the unit’s staff

and management.

A unit-based task force was formed under

the guidance of the unit leader with the

participation of frontline staff nurses, an

infection preventionist, the medical director,

and a clinical educator. A new action plan

was officially implemented in September

2015 and focused heavily on education and

audits. Unit leaders ran a REDCap survey

among staff to assess their understanding

of policy and current practice. Teams then

reviewed current evidence, CDC guidelines,

and recommendations from other relat-

ed professional organizations. One of the

biggest changes made was to switch the

unit’s central line cap and tubing change

from once to twice each week as a trial for

three months. Based on the REDCap survey

results, training and validation of central line

care skill was mandated for all unit-based

High-Risk Oncology Unit Turns CLABSI Rate Around With Education, Audits, Teamwork

and float staff. But the plan would not have

been complete without some important

players outside the unit as well: The hospital

CLABSI committee and physician champi-

ons offered their input, expertise, and con-

stant support, and the float pool leadership

and staff proved their flexibility by working

alongside the unit during the whole process.

The desired outcome of the initiative was

that 11 South would achieve and maintain

a National Health Safety Network (NHSN)

standardized infection ratio (SIR) of less than

1.0 for CLABSI, which is the gold standard

across the nation for similar populations of

patients, and to disseminate best practices

and outcomes learned from the initiative to

other departments locally and nationally. As

the graph above shows, the unit’s improve-

ment was notable once the action plan was

implemented.

10

9

8

7

6

5

4

3

2

1

0

Num

ber

of C

LAB

SI r

epor

ted

Bone Marrow Transplant – CLABSI Data 2015-2016

7.0 7.0

9.0

2.0 3.0

1.0 1.0

Intervention

Post-InterventionPre-Intervention

Mar-15 Jun-15 Sep-15 Dec-15 Mar-16 Jun-16 Sep-16

It Takes a Team to Support Patient

Experience

On September 28, 2016, an 11 North transi-

tional care coordinator/social worker informed

the 11 North team that an end-of-life patient

on the unit expressed that his last wish was

to celebrate Christmas with his family. The

staff jumped into action and collaborated

with several areas of the hospital to obtain

items so that his wish could be granted. Staff

from 10 North, the Medical Intensive Care

Unit, and Nutrition were called and together

were able to provide Christmas decorations

and a Christmas tree, enabling 11 North

staff to decorate the patient’s room, which

looked awesome! The patient was awake

and alert, and he was full of smiles when

he saw it. Nutrition was also called to see

if a meal could be prepared for the patient.

Within 15 minutes, the call was returned with

a Christmas meal menu for the whole family!

All of this – the tree, the room decorations,

and the family meal with all the trimmings –

happened within three hours of the staff being

notified of the patient’s wishes. The patient’s

family was overwhelmed with everything and

amazed that the 11 North staff was able to

accomplish all of this in such a short time.

The family was very happy, and the greatest

joy was that the patient was awake to enjoy it

all and celebrate Christmas with his family as

he wished. He passed that night around mid-

night. The experience reminded all involved

of the specialness of caring for patients and

their families, one day at a time.

In 2016, the Enterostomal Nursing Depart-

ment at UT Southwestern changed its name

to the Wound Ostomy Department. In recent

years, UTSW’s wound ostomy program has

grown from a “department” of one to now

eight certified Wound Ostomy Continence

Nurses (WOCNCB). This team specializes in

all aspects of skin care and ostomy manage-

ment, providing care to patients at both Zale

Lipshy and Clements University Hospitals. In

2016, the team began offering ostomy clinics

at offsite ambulatory clinics as well, ending the

fiscal year having treated hundreds of patients

for chronic wounds and having attained a

healing rate of 95 percent.

Wound Ostomy Team Grows, Expands Services

Rebekah Gandara, B.S.N., RN, CRRN (left), and Diana Dobbins, A.D.N., RN

Exemplary Professional Practice 35Exemplary Professional Practice34

Leader Development

Due to the increased complexity, acuity, and

overall volume of the patient population at

Zale Lipshy University Hospital, four Assistant

Nurse Managers developed and submitted

a formal proposal to the Manager, Director,

CNE, and CFO requesting an adjustment to

the budgeted FTEs (full-time equivalents) for

the hospital to support patient care acuity

and staffing needs.

The ANMs – Laura Duran, M.S.N., RN;

Maria Darauay, B.S.N., RN; Maria Flores,

B.S.N., RN; and Steven Sisson, B.S.N.,

RN – developed an acuity tool outlining

specific care needs by patient diagnosis

and type. They also conducted a literature

review of clinical practice guidelines for

patient populations, as well as an outside

organizational practice comparison. They

then classified eight months of unit-specific

patient data into two separate assignment

models and identified the historical volume

for each assignment model for the average

daily census, using the calculated results to

arrive at the required FTEs.

Thus, based on patient and unit-specific

clinical and financial data, the ANMs’ proposal

resulted in staffing adjustments to meet the

increased care needs. The experience also

gave the ANMs the opportunity to understand

the elements involved in making budgetary

requests and decisions, which previously had

been done at a Manager level or above.

Imaging Services Nursing

A unit goal of the Imaging Services Nursing

Department is to “reduce patient suffering”

in every way possible. Imaging Services is

accomplishing this goal by:

n Reviewing and revising workflow processes for more patient-centric care

n Reviewing barriers causing procedural delays and collaborating with Imaging Services modalities and physicians to reduce delays and increase patient satisfaction

n Increasing the exchange of information/ expertise between Imaging nursing and Imaging Services leadership and radiologists, all working collaboratively to increase patient satisfaction and decrease procedural delays to include introduction of the “mini huddle” and procedure delay report

n Enhancing the connection to the patient through communication before and after procedure phone calls

“This was the absolute kindest staff that we have ever encountered in a hospital.”

Outpatient Clinics

Satellite Clinics: Transplants

Across Texas

Patients needing evaluation for lung, kidney,

or liver transplants can be referred to UT

Southwestern outpatient clinics located

in seven cities across Texas. Patients can

receive pre-transplant consultation services

and post-transplant follow-up care at these

satellite clinics – which are staffed by UT

Southwestern transplant teams, including

specialty nursing staff – while all trans-

plant surgeries take place in Dallas at UT

Southwestern’s state-of-the-art William P.

Clements Jr. University Hospital.

Advanced Practice Nurses

Nationally certified and state licensed,

Advanced Practice Providers (APPs) at UT

Southwestern include clinical nurse spe-

cialists (CNSs), nurse practitioners (NPs),

physician assistants (PAs), certified nurse

midwives (CNMs), and advanced practice

registered nurses (APRNs).

In 2016, APP Director Rhonda Hough,

D.N.P., APRN, CPNP-AC, introduced the

role of the Assistant Director into the UT

Southwestern APP leadership structure. This

was the result of a rapidly expanding number

of APPs hired to practice across the UTSW

health system. This growth accentuated the

essential need for APP specific professional

development, education/training, and role

development. This expanded APP leadership

included the introduction of four Assistant

Directors to complement Dr. Hough’s work.

These four individuals work in the areas

reflective of both their clinical expertise and

administrative experience. The Assistant

Director integration provides expertise in

the recruitment of qualified candidates,

ensures that initial and ongoing training and

education meet applicable standards, and

provides direct administrative supervision

to staff within particular areas. These efforts

also provide the organization with enhance-

ments surrounding APP clinical competency,

intentional professional development, and

improved compliance with regulatory rules.

These APP leaders are helping to bridge

this gap by partnering with current leaders

and by supplying the necessary support and

resources to those providers.

The Assistant Directors are:

Aimee T. Dunnam, APRN,

NNP-BC – University Hospitals

Christopher McLarty, CNP, APRN,

ENP-BC – Ambulatory Services

Kimberly George, M.S.N., APRN, ACNS-

BC, ONC – Simmons Comprehensive

Cancer Center

Kimberly Oas, M.S.N., APRN, FNP-BC –

Peter O’Donnell Jr. Brain Institute

El Paso Midland

Lubbock

Amarillo

Austin

Fort Worth

Tyler

AmarilloEl PasoLubbockMidlandTyler

Lung Kidney Liver

AmarilloLubbock

AustinEl PasoFort WorthLubbock

Exemplary Professional Practice 37Exemplary Professional Practice36

Debbie Arbique, D.N.P., FNP-C, CEN, CFN,

APRN, DABFN, FACFEI

Category: Innovation, Research, and

Evidence-Based Practice

Debbie Arbique is a Doctor of Nursing

Practice and board-certified family nurse

practitioner with broad research, clinical,

and teaching experience spanning a 21-year

career at UT Southwestern. Dr. Arbique cur-

rently works clinically in the UT Southwestern

Division of Cardiology’s Hypertension Section,

where she is also a Research Coordinator

and Sub-Investigator, roles in which she

participates in a number of research studies.

In the clinical setting, Dr. Arbique serves as a

blood pressure specialist, caring for patients

with hypertension, hypotension, and neuro-

genic orthostatic hypotension. In the lab, she

is currently involved in more than 10 research

studies, including: “Mechanisms of Mus-

cle Blood Flow Dysregulation and Exercise

Intolerance in Chronic Kidney Disease”;

“Detection of Adherence to Antihypertensive

Medications with Therapeutic Drug Mon-

itoring”; “Usefulness of Ambulatory Blood

Pressure Monitoring and Cold Pressor Test in

Detecting Autonomic Failure”; “Neural Mech-

anisms of Tyrosine Kinase Inhibitor-Induced

Hypertension in Humans”; “Blood Pressure

Outcomes in Anti-Vascular Endothelial

Growth Factor Receptor (VEGFR)/Tyrosine

Kinase Inhibitor (TKI)-Induced Hypertension”;

“The Role of Aldosterone on Augmented

Exercise Pressor Reflex in Hypertension:

Outcomes in Patients With Primary Aldoste-

ronism Treated With Adrenalectomy or Min-

eralocorticoid Receptor Antagonists”; “Pilot

Study to Determine Prevalence of Non-adher-

ence to Antihypertensive Medications in the

Primary Care Clinics”; “Neural Mechanisms of

Aldosterone-Induced Insulin Resistance”; and

“Preventing Metabolic Side Effects of Thiazide

Diuretics With KMgCitrate.”

Advanced Practice Nurses

In 2016, Dr. Arbique’s contributions to

research led to the publication of two

manuscripts;

Velasco A, Solow E, Price A, Wang Z, Arbique

D, Arbique G, Adams-Huet B, Schwedhelm E,

Lindner J, and Vongpatanasin W. “Differential

Effects of Nebivolol vs Metoprolol on Micro-

vascular Function in Hypertensive Humans.”

American Journal of Physiology: Heart and

Circulatory Physiology, May 2016.

Vongpatanasin W, Peri-Okonny P, Velasco

A, Arbique D, Wang Z, Ravikumar P, Ad-

ams-Huet B, Moe OW, and Pak CY. “Effects

of Potassium Magnesium Citrate Supplemen-

tation on 24-Hour Ambulatory Blood Pressure

and Oxidative Stress Marker in Pre-hyperten-

sive and Hypertensive Subjects.” The Ameri-

can Journal of Cardiology, June 2016.

Dr. Arbique is an active member on both

the UT Southwestern Medical Center and

Parkland Health & Hospital System Ethics

committees, for which in 2016 she presented

on the topic “Policy Development & Orga-

nizational Issues: Ethics Committees and

Distributive Justice.”

Dr. Arbique also volunteers in the community

extensively. Her community involvement

includes service with the DeSoto Police

Department as a Citizen on Patrol, for which

she received the Volunteer of the Year Award

on April 16, 2016. Dr. Arbique regularly

conducts health fairs at the police department,

checking blood pressures and educating the

community about healthy lifestyles. In addition,

she leads numerous Heartsaver/AED/First

Aid classes, both at the police department and

elsewhere in the community on weekends.

Debbie Arbique, D.N.P., FNP-C, CEN, CFN, APRN, DABFN, FACFEI

Keri Draganic, D.N.P., ACNP-BC

Category: Quality Improvement

and Outcomes

Keri Draganic is a Doctor of Nursing Practice

in the Division of Cardiovascular and Thoracic

Surgery at UT Southwestern Medical Center,

where she provides care to patients after

cardiovascular or thoracic surgery and at

the point where healing and recovery begin.

Although her tenure at UTSW has been short,

she has demonstrated a willingness to inves-

tigate the evidence for best practices and the

implications for her patients.

One way Dr. Draganic demonstrates her pas-

sion for her patients is looking at quality im-

provement initiatives. She has an avid interest

in treating sepsis within the adult population,

which includes specifically fluid resuscitation

in the treatment of sepsis in patients with

underlying congestive heart failure (CHF). For

her Doctorate of Nursing Practice (D.N.P.)

capstone project, Dr. Draganic chose a ret-

rospective review of outcomes in septic CHF

patients who received the recommended

intravenous fluid (IVF) resuscitation described

by the Surviving Sepsis Bundle versus

those who received more or less.

She also made a commitment to profes-

sional development through her partici-

pation in the Advanced Practice Provider

(APP) Clinical Ladder and entry into the

Neuroscience Nursing Research Center

(NNRC) Fellowship program at UTSW. Dr.

Draganic was one of six nurses and the

first APP to be accepted into the pro-

gram in its second graduating class. Her

participation included 1:1 mentorship with

members of the NNRC, which provided

her with direction and served to keep her

on track to graduation with her D.N.P. in

December 2016.

Other examples of Dr. Draganic’s involve-

ment at UTSW include her grant submission

to the Doris Bloch Foundation for research

funding for her study on preoperative

PT values to postoperative therapeutic

Coumadin levels in patients with mechan-

ical valve replacement. In addition, she

conducted a Journal Club presentation on

transfemoral aortic valve replacement and

was recently nominated and has accepted

the Co-Chair of the Nursing Research and

Evidence-Based Practice Committee.

Finally, outside of caring for patients and

research, Dr. Draganic holds member-

ships in various professional organizations,

including the American Association of Nurse

Practitioners (AANP), North Texas Nurse

Practitioners (NTNP), American Association

of Critical Care Nurses (AACN), and Society

of Critical Care Medicine (SCCM). She is a

wonderful asset to UTSW, where her enthu-

siasm and passion are contagious.

Keri Draganic, D.N.P., ACNP-BC

Exemplary Professional Practice 39Exemplary Professional Practice38

Leticia Khosama, M.S.N., APRN,

NP-C, AOCNP

Leticia was recognized as the UT South-

western 2016 APRN of the Year, demon-

strating exceptional performance in several

categories: being a role model, providing

leadership, serving the community, and being

a compassionate caregiver. Leticia received

accolades from patients and co-workers for

her consistently compassionate, intelligent,

and comprehensive care.

Leticia graduated from nursing school magna

cum laude in 2005 and began working with

oncology patients in 2007; that was when

she “found her calling.” Her work began in

the Parkland Oncology Clinic, and she gradu-

ated with her M.S.N. in 2012, while serving

as a GI/GU nurse navigator. Her passion for

her patient population continued into her

APRN role as a GI/GU Medical-Oncology

APRN and is evident in her involvement in

multiple clinical research studies in coordina-

tion with the Clinical Research Office.

Leticia has achieved national certification in

her specialty (AOCNP) and is an active mem-

ber of the Oncology Nursing Society.

Since February 2013, Leticia has volunteered

at GDAS Cancer Clinic in Plano, providing

care for underprivileged patients who don’t

live in Dallas County.

Leticia’s abstract (in collaboration with Mu-

hammad Beg, M.D.), “Interaction Between

Regorafenib and Warfarin Therapy,” was ac-

cepted for a poster presentation at the 2017

Gastrointestinal Cancers Symposium (AS-

CO-American Society of Clinical Oncology).

Leticia Khosama, M.S.N., APRN, NP-C, AOCNP

“The nurses were, from

start to finish, upbeat,

friendly, and very positive,

very willing to help.”

Lakina Ferguson, A.D., RN

Exemplary Professional Practice 41Exemplary Professional Practice40

Huddle: An Old Concept Made New Again

In order to improve patient throughput

and match resources with needs, nurses

from 10 North, 12 North, and 12 South

implemented a “bed huddle” initiative

involving three inpatient units. Huddling is a

collaborative process whereby Emergency

Department patients, transfer patients, and

direct admits are placed in the unit with

the first available bed and staff to provide

care. Successful implementation required

hospitalist provider input into placement

for geographical assignments and unit staff

input for patient placement in the unit with

the most available resources, all in real

time. The resulting decreased wait time

for bed placement led directly to patient,

provider, and staff satisfaction.

CVICU Surpasses Milestones in 2016

The mission of the CVICU is to provide

compassionate, quality care that is respect-

ful, patient- and family-centered, safe, and

cost-efficient. CVICU patients are primarily

adults, but postoperative adolescent cardio-

thoracic surgical patients who can be treated

with adult protocols and equipment may also

be admitted to the CVICU.

The CVICU has the only nurse-driven adult

ECMO program in the Dallas-Fort Worth

area, as well as the nation’s only nurse-driven

ex-vivo program for potential lung transplant

organs. In early 2016, the CVICU medical

and surgical faculty performed the first

combined liver/lung transplant. The unit has

achieved more than 500 heart transplants

and is on its way to surpassing 1,000 lung

transplants. The CVICU staff is participating in

the Nurse Residency Program this year and

also has accepted three internal candidates

for the unit’s CAT program. The nursing team

is active in the ongoing work with the collab-

orative Anesthesia/Surgeon ECHO to ICU

handoff project.

Charge to Charge

CN Lead to hospital admitter

Hospital admitter to bed control

Bed Huddle 0800/2000/PRN

Charge RN# 10N-38660—12N-73017—12S-38278

Lead Charge RN communicates with 10N/12N/12S CN

Beds available

RN open for admits

Pending DCs

Preferred bed assignment

Lead Charge RN communicated with hospitalist admitter

Beds available/with open RN

Preferred 1st/2nd/3rd bed available

PD pts. routed to 10N, ACE pts. to 125

Reviews targeted discharges

Hospitalist admitter will request beds as per huddle as admissions are received. PD will be placed on 10N. CNs will communicate between units and HA as needed throughout shift.

End-of-life care can involve frequent

interruptions to patients and their fami-

lies, adjustments to visitor guidelines, and

changes in orders and expectations of care

(affecting labs, X-rays, consults). End-of-life

settings also can involve surprises, such as

ancillary staff members witnessing a situa-

tion they may not be prepared to encounter.

Other ancillary staff might enter a room for

a patient discussion or evaluation that is no

longer appropriate to the patient’s care.

The 8 South nurses surmised that such

instances could easily be avoided once an

appropriate symbol was found and the staff

was educated on its purpose and meaning.

Placing the symbol on the patient’s door

when he/she had transitioned into end-of-

life care would, nurses believed, promote

an environment of tranquility and privacy by

decreasing unnecessary interruptions to pa-

tients and families during end-of-life care and

thereby also promote dignity for all involved.

The unit created the butterfly as its end-of-

life symbol and began using it as needed

in September 2016. The MICU anticipates

continuing the signage indefinitely, and 8

South has had requests from other units to

make the signage a hospital-wide initiative.

Improving the Nurse-Patient Connection

Through Communication

A team of nurses and nurse leaders across

five units put into place a Meaningful Patient

Connection (MPC) initiative to improve

patients’ perception of communication with

nurses. The goal was to enhance patients’

overall communication with nurses and

ensure patients felt their nurses treated

them with courtesy and respect, listened to

Medical ICU Nurses Initiate End-of-Life

‘Butterfly Project’

Signage is widely accepted as a form of

communication within the hospital setting,

whether it’s to denote hazards, cautions, ex-

its, restricted areas, or other messages that

can be symbolically conveyed to affect staff

behavioral and situational expectations.

Nurses on Unit 8 South, a medical intensive

care unit at Clements University Hospital,

provide a high volume of end-of-life care and

are experts in meeting the specific needs of

this patient population and their families. The

bedside RN is the coordinator of care. When

goals of care change, the nurse is pivotal

to updating all staff involved in care. Prior

to September 2016, there was no signage

to indicate to the unit and to ancillary staff

that a particular patient’s goal of care had

transitioned to end-of-life care. Nurses, led

by Nurse Manager Ruben Castillo, M.S.N.,

B.S.N., RN, and Candice Coker, B.S.N., RN,

saw a benefit in having such signage and

launched the “Butterfly Project.”

them carefully, and explained things in an

understandable way. New or revisited pro-

cesses put into place to improve the patient

experience included:

n A reintroduction to AIDET (Acknowledge, Introduce, Duration, Explanation, and Thank You)

n Commit to sit/engage

n Hourly rounding

n Bedside shift reports

n Use of whiteboards

Using these hardwired evidence-based ini-

tiatives, which are proven to have a positive

impact on patient satisfaction and engage-

ment, the multiple units improved patient

scores on both fronts.

In choosing the butterfly as the end-of-life

symbol for the signage, the unit’s nurses

consulted the Palliative and Supportive Care

team and conducted a literature review. That

review revealed that while similar signage is

commonly used in pediatric and women’s

health and is recommended, there is minimal

data on the use of signage in adult popula-

tions to indicate an end-of-life setting.

Percentile Ranking, Large PG Database

9494

57

92 89100

80

60

40

53 5361

4/1–6/30/16

8/1–10/31/16

Initial Results—4/1–6/30/16 vs 8/1–10/31/16

Communication with nurses

Nurses treat with courtesy/respect

Nurses listen carefully to you

Nurses explain in way you understand

The team involved in this initiative included:

Ruben Castillo, M.S.N., B.S.N., RN, CCRN,

Nurse Manager, 8 South Medical Intensive

Care Unit

Kavitha Nair, B.S.N., RN, OCN, Nurse

Manager, 11 South Bone Marrow Transplant/

Oncology

Nancy Neal, B.S.N., RN, Nurse Manager,

12 North and 12 South, Medicine Units

Amy (Flores) Johnson, B.S.N., RN, Nurse

Manager, 10 North Medicine Unit

Valerie Brooks, M.H.A., B.S.N., RN, Nurse

Manager Surgical Oncology, 11 North

Lori Hodge, D.N.P., RN, OCN, NEA-BC,

Director, Medical & Oncology Services

Kathy Price, M.A., MT(ASCP), CSSBB,

Director, Lean Six Sigma

Dee Taylor-Akins, M.S., SPHR, SHRM-SCP,

Sr. Organizational Development Consultant

Exemplary Professional Practice 43Exemplary Professional Practice42

Apheresis Clinic Improves Patient Safety

With MEWS Scoring

Over the years, health care clinicians have

become aware of the significant physiologic

deterioration in patients prior to a Code Blue

event. The use of Rapid Response Teams

(RRTs) for early intervention to decrease

the clinical problem of rescue failure while

also decreasing mortality and morbidity has

gained deserved recognition. The purpose

of this project was to examine the use of

the Modified Early Warning System (MEWS)

scoring via the electronic medical record

(EMR) in the Apheresis Clinic to reduce

sentinel events. Standardization of vital sign

limits within MEWS acts as a common un-

derstanding of when to call the RRT to help

manage patient care.

The Clinic’s aim in this project was to de-

crease Code Blue and other adverse events

and increase the use of the RRTs through

earlier identification for at-risk patients.

MEWS scoring was implemented in Octo-

ber 2015 with data collection occurring until

October 2016.

Decreasing sentinel events in the Apheresis

Clinic with the use of advanced assessment

and use of the RRTs involved:

n Comparing patient safety before and after implementing MEWS in the Apheresis Clinic from October 2015 to October 2016.

n All patients visiting the Clinic received an assessment of MEWS vital signs regardless of their diagnosis or reason for being at the clinic. This includes assessing the patient’s temperature, heart rate, and respiratory rate (which in turn includes oxygen saturation, blood pressure, and neurological mentation).

n The preclinical data presented an opportunity for improvement to decrease unanticipated events in the Apheresis Clinic. The existing MEWS scoring from the in-patient setting was added to the apheresis patient’s EMR. Apheresis clinicians were educated on the UTSW standard operation procedure of MEWS. Patients at risk were identified with a

Aston Ambulatory Services Rolls Out

Patient Responsiveness Initiative

As part of seven strategic initiatives set by the

Ambulatory Services Committee, the Patient

Responsiveness Initiative seeks to improve

ambulatory services response times to patient

telephone calls, MyChart messages, and

refill requests. The Project Team, made up of

ambulatory triage RNs, data management

analysts, and outside consultants, are working

with each clinic to assess current clinic prac-

tices, implement a telephone triage decision

support tool, and redeploy nurses and clinical

staff to support telephone triage and in-clinic

functions. The initiative also includes develop-

ment of health system standards for respond-

ing to patient messages, guidelines for division

of work that allow nurses and clinical staff to

work to the top of their license, certification,

training, and skill set, and recommendations

for clinic-specific staffing and productivity

standards for nurses and other clinical staff.

The initiatives goals are to:

n Decrease turnaround time for patient messages

n Get patients the right level of care at the right time

n Improve workflow efficiencies in the clinic to decrease throughput times and to decrease follow-up items after appointments

n Increase patient, staff, and provider satisfaction

In conjunction with this initiative, a new

course was made available in 2016 for all

existing RNs throughout the ambulatory

clinics and incorporated into new ambulatory

RN orientation. Titled “Enhancing the Role of

RNs in Ambulatory Care: Telephone Triage

& Epic Decision Support Tools,” the course

covers topics such as care coordination, top-

of-license practice, and the value of the RN in

ambulatory care. It is designed to inspire RNs

taking the course to feel empowered and

valued as an integral component of the care

that is provided at UTSW.

Leaders in the Community

One of the most rewarding ways UT South-

western nurses share their experience with

the community is by lending their skills,

knowledge, and time as volunteers. From

formal volunteer programs to impromptu acts

of service, our nurses make a difference in

the health and well-being of their local com-

munities while also bettering themselves as

nurses by offering their services and lending

a hand. UT Southwestern encourages the

nursing staff to participate in many ways and

through many local entities, sharing their ex-

pertise and developing professionally through

community involvement.

1016

26

14

16

18

Nurse Community Involvement

Public Health

Education and Schools

Walks

Shelters and Food Banks

Festivals and Religious Gatherings

Other

visual score before procedures, during a procedure, and at discharge. The MEWS vital sign parameters were also added to the apheresis order sets, along with setting the alarm limits on the cardiac monitors within the unit to match MEWS scoring vital sign limits. A collaboration with RRTs was established with the implementation of MEWS scoring in the Clinic and when to initiate an advanced assessment.

Variable

Study Months

Patient Encounters

Code Blue

Clinic RRT

Lobby Rescues

Pre-MEWS

Jan-Sept 2015

375/month

2

11

5

Post-MEWS

Oct 2015-Oct 2016

447/month

0

47

1

P-Value

N/A

N/A

0.12

<0.001

0.62

Results Before and After Implementation of MEWS

Modified Early Warning System (MEWS), Rapid Response Team (RRT)

%

New Knowledge, Innovation, and Research 45New Knowledge, Innovation, and Research44

New Knowledge, Innovation, and Research

UT Southwestern Medical Center’s Nursing Research Program has two strong programs

to support nursing research within the hospitals and hospital-based clinics. Structures

and processes have been developed and implemented to involve more nurses at all lev-

els in the research process and in disseminating new nursing knowledge gained through

research efforts.

The Nursing Research and Evidence-Based Practice Council (NREBPC) works diligently

with its members and nurses across the organization to stimulate research ideas and

create an environment of scientific inquiry. The Neuroscience Nursing Research Center

(NNRC) is dedicated to ensuring that nurses at all levels are able to provide vital research

contributions to the science of caring for patients with neurological illness.

Vital Research Contributed by Nurses

NNRC 2016 FellowsBack Row: Linda Chan, B.S.N., RN, OCN; DaiWai Olson, Ph.D., RN, CCRN, FNCS; Sonja Stutzman, Ph.D. Middle Row: Natalie Martinez, M.S.N., RN, FNP; Linda Dobson, B.S.N., RN; Tobi Duncan, B.S.N., RN, OCN; Rocky Sonemangkhara, B.S.N. RN Front Row: Samarpita Sengupta, Ph.D.; Emelita Bennett, B.S.N., RN, CCRN; Charlene Supnet, Ph.D.

Nursing Research and Evidence-Based Practice CouncilBack Row: Tomas Armendariz, B.S.N., RN, CMSRN; Shelli Chernesky, M.S.N., RN, CCRN, NE-BC; Karen Martin, M.S., RN, SCNS, CWOCN; Linda Chan, B.S.N., RN, OCN; Autumn Webb, M.B.A., B.S.N., RN, CCRN; Keri Draganic, D.N.P., APRN, ACNP-BC; Maria Grabowski, M.S.N., RN, OCNMiddle Row: Jean Hoyt-Sehnert, M.S., B.S.N., RN, NEA-BC; Stefanie Crain, B.S.N., RN; Catherine Bailey (TWU), M.S., Ph.D.; Kelli Hulsman, M.S., IBCKC, LCCEFront Row: Amy Weaver, M.S.H.A., B.S.N., RN, CEN; Stephanie Huckaby, M.S.N., RN, RN-BC; Deb Spitzer, M.S.N., RN, OCN

“Everybody was knowledgeable

and kind. They clearly knew

what they were doing and

did it well.”

New Knowledge, Innovation, and Research 47New Knowledge, Innovation, and Research46

T hroughout 2016, UT Southwestern

nurses were involved in nursing

research and evidence-based

practice initiatives in specific areas.

Many either published their research or pre-

sented their findings in poster and/or podium

presentations at professional gatherings

locally and across the country. Some of this

nursing-led research is noted below and on

the following pages.

Evidence-Based Practice and

Research 2016

Kamal Abdulkhadir, B.S.N., RN, NIHSS.

ECHO-ICU enhancing communications

for handovers from the operating room to

the ICU.

Susan Alex, APRN, ANP-BC. Identifying

barriers to nurse compliance with depression

screening in stroke patients.

Tomas Armendariz, B.S.N., RN, CMSRN,

Shelli Chernesky, M.S.N., M.B.A., RN,

CCRN, Julie Earnest, M.S.N., M.B.A., RN,

CCRN, Dara Mariani, B.S.N., RN, CCRN,

and James West, B.S.N., RN. Rapid

response … using MEWS in apheresis.

Tamara Bennett, B.S.N., RN. END-PANIC –

pupil study in ICU.

April Crow, B.S.N., RN, and Maureen

LeDanseur, M.S.N., APRN, ACNS-BS.

Music rehab.

Rebecca Dill, B.S.N., RN. The impact of

motivational interviewing on self-perceived

burden in chronic neurologica patients

(MI-patients).

Amanda Dirickson, FNP, and Maddy

Stewart, RN. HER stroke.

Keri Draganic, D.N.P., APRN, ACNP-BC. A

retrospective review of preoperative PT value

to postoperative Coumadin levels in mechan-

ical valve replacement patients (POT-C).

Taylor Jensen, B.S.N., RN. So long to PONG.

Michael Levy, RN, ACNP-BC, CNRN. Inci-

dence of local pin site inflammation following

Gamma Knife procedure (Ipin study).

Karen Martin, M.S.N., RN, ACNS, CWOCN,

and DaiWai Olson, Ph.D., RN, CCRN,

FNCS. Language of data II.

Karen Martin, M.S.N., RN, ACNS, CWOCN,

and DaiWai Olson, Ph.D., RN, CCRN,

FNCS. Language of data III.

Linda Merritt, M.S.N., RN, and Stephanie

Huckaby, M.S.N., RN, NEA-BC. Determining

the needs of fathers of premature neonates.

Kelly Moore, RN. Investigating the onset

of chemobrain in chemotherapy patients: A

comparison of early versus late onset.

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

DIMINSUNS.

DaiWai Olson, Ph.D., RN, CCRN, FNCS,

Margaret Dupre, Meg Wilson, B.S.N., RN,

CCRN, Jennifer Wilson, and Sondra Perez.

Prosper-patient-centered research into out-

comes stroke patients prefer and effective-

ness research.

DaiWai Olson, Ph.D., RN, CCRN, FNCS,

and Shelli Cherneski, M.S.N., M.B.A., RN,

CCRN. Stroke readiness.

Melissa Panter, B.S.N., RN. Is an algorithm

for deciding PICC vs midline access superior

to medical experience? (ADVISE ME.)

Jannelle Plourde, B.S.N., RN. Perception

survey of nursing education & training of

peripherally inserted central line catheters in

MICU and SICU.

Michelle Roberson, B.S.N., RN. Ambulation

outcomes in patient > 65 years old.

Michael Rogers, B.S.N., RN, CCRN. Wait

a tic – Agnes Marshall Walker Foundation

research grant.

Andres Rozo, B.S.N., RN, and Hliang Thu,

RN. FACES.

Kathrina Siaron, RN. Socrates.

Annamma Stephen, B.S.N., RN, CCRN.

CHUP.

Keri Draganic, D.N.P., APRN, ACNP-BC.

CHF M&M post-sepsis resuscitation.

Victoria England, M.B.A., B.S.N., RN, NE-

BC. Patient supply servers save steps?

Maria Grabowski, M.S.N., RN, OCN, Deb

Spitzer, M.S.N. OCN, Shaghayegh Rezaie,

M.S., B.S.N., RN, OCN, Catherine Close,

B.S.N., RN, OCN, and DaWai OIson, Ph.D.,

RN, CCRN, FNCS. How nursing attitudes

and education needs may add barriers to

patient discussion on fertility preservation for

cancer patients.

Kim Harrison, B.S.N., RN, CCRN, and

Desiree Low, RN. ON RAMP.

Meghan Hoffman, B.S.N., RN. NBP/ABP

study.

Max Holder, B.S.N., RN. Ultrasound and IV

impact on DVT.

Kelli Hulsman, B.S.N., RN, IBCLC, LCCE.

Maternity practices associated with infant

feeding following hospital discharge: A multi-

site study.

Nursing-Led Research in 2016 Austin Tucker, B.S.N., RN, and Karen

Martin, M.S.N., ACNS, CWOCN, RN. No

more BS!

Diana Vasil, B.S.N., RNC-NIC. The introduc-

tion of clinical research trials to the NICU.

Holly Ware, B.S.N., RN. BETCHA.

Amy Weaver, M.S.H.A., B.S.N., RN, CEN,

DaiWai Olson, Ph.D., RN, CCRN, FNCS,

and Sonja Stutzman, Ph.D. ARAMIS study

(in stroke patients on new drug).

Amy Weaver, M.S.H.A., B.S.N., RN, CEN,

DaiWai Olson, Ph.D., RN, CCRN, FNCS,

and Carry Orrick, B.S.N., RN, CEN. CATCH

– diabetes in ER management.

James West, B.S.N., RN. Formatting an

experiential learning education module to en-

courage dysphagia assessment in apheresis

patients (FEED ME).

Publications in 2016

Bazil J. “AACN procedure manual.” [Co-au-

thor of chapter.] Critical Care Nursing Clinics

of North America, 2016.

Dirickson A, Jones D, Riise L, and Olson

D. “Safety and efficacy of nurse-driven acute

stroke care.” Journal of Stroke and Cerebro-

vascular Disease (submitted).

Elmore K. “Hypertension.” MedSurg Matters.

In press.

Holder M, “IV placement using conventional

versus ultrasound-guided techniques.”

Journal of Infusion Nursing, May 2016.

Huckaby S. “Chapter 3: Research evidence

in nursing practice.” Foundations of Nursing

Research, 7th edition [co-author] (submitted).

LeDanseur M, Olson D, and Stutzman S.

“Is the CABIC clean intermittent catheteriza-

tion patient education effective?” Journal of

Rehabilitative Nursing. In press.

Levy M, Stevenson S, Stutzman S,

Whitworth L, and Olson D. “Incidence of

local pin-site inflammation after Gamma Knife

procedure.” Radiology Nursing. In press.

Luke Mahan, M.S.N., FNP

44

42

40

38

36

34

32

0

Division of Nursing – Nurse-Led Research Projects That Affect Patient Outcomes

Research Comparison 2015 – 2016

2015 2016

New Knowledge, Innovation, and Research 49New Knowledge, Innovation, and Research48

Stutzman S, Olson D, Greilich P, Abdulkadir

K, and Rubin M. “Transferring care from the

OR to the ICU: A qualitative inquiry of patients’

and families’ experiences.” Association of

Perio-Operative Registered Nurses Journal.

In press.

Stutzman S, Olson D, Supnet C, Harper C,

Brown-Cleere S, McCulley B, and Goldberg

M. “Promoting bedside nurse-led research

through a dedicated neuroscience nursing

research fellowship.” Journal of Nursing

Administration, Dec 2016.

Supnet C, Crow A, Stutzman S, and

Olson D. “Music as medicine: The therapeutic

potential of music for neurological injury.”

Critical Care Nurse, April 2016, 36(2): e1-e7.

Ware H, Stutzman S, McGarry L, Bland J,

and Olson D. “Does neurofunction monitor-

ing enhance nursing confidence and com-

fort?” Pain Management Nursing (submitted).

Weaver A, Hernandez S, and Olson D.

“TeamSTEPPS study.” Journal of Nursing

Administration (submitted).

Weaver A, Stutzman S, Supnet C, and

Olson D. “Sleep quality, but not quantity,

is associated with self-perceived minor error

rates amongst emergency department

nurses.” International Emergency Nursing,

March 2016, 25: 48-52.

Zhao W, Stutzman S, Saju C, Olson D,

Wilson M, and Aiyagari V. “Inter-device

reliability of the Npi-100 pupillometer.”

Journal of Clinical Neuroscience, May 2016.

As evidence of our organizational com-

mitment to professional development, UT

Southwestern supports attendance at local,

regional, and national conferences. Financial

support for continuing education is aligned

with organizational priorities and initiatives.

Full or partial funding is awarded based on

the nurse presenting a poster or delivering

a presentation at the podium. Over the past

three years, we have taken an increasingly

forward-looking approach to supporting our

nurses in participating in key conferences

through poster and podium presentations.

This approach supports our leadership’s stra-

tegic goal of positively impacting the nursing

profession at UT Southwestern and beyond.

Podium Presentations by

UT Southwestern Nurses in 2016

Rebecca Dill, B.S.N., RN, Jennifer Wintz,

B.S.N., RN, Shelli Chernesky, M.S.N.,

M.B.A., RN, CCRN, Lisa Dalton, M.S.N.,

M.B.A., RN, NE-BC, Sean Yates, M.D., Ni-

cole DeSimone, M.D., Ravi Sarode, M.D.,

and Karen Matevosyan, M.D. “Comparison

of Norfolk sport port and angiodynamic vor-

tex ports for therapeutic plasma exchange.”

American Society of Apheresis 2016 Annual

Meeting, Palm Springs, Calif., May 2016.

Amanda Dirickson, M.S., ANP-C, APRN,

SCRN. “The simple fact of cerebral vasculitis.”

American Association of Neuroscience

Nurses, New Orleans, La., April 2016.

Amanda Dirickson, M.S., ANP-C, APRN,

SCRN. “The simple fact of cerebral vasculitis.”

UT Southwestern Zale Lipshy University

Hospital, Dallas, Texas, May 2016.

Nurse Presentations and Posters

Victoria England, M.B.A., B.S.N., RN, NE-

BC. “Getting off to a good start.” Dallas-Fort

Worth Hospital Council Preceptor Academy,

Medical City Dallas Hospital, Dallas, Texas,

Jan. 21, 2016; Texas Woman’s University,

Dallas, Texas, June 16, 2016; Parallon Busi-

ness Performance Group, Irving, Texas,

Aug. 30, 2016; Texas Health Resources,

Arlington, Texas, Oct. 21, 2016.

Max Holder, B.S.N., RN. “The impact of US

guided IV placement on vein thrombosis risk.”

South Florida Chapter of the Infusion Nurses

Society 3rd Annual Conference, Miami, Fla.,

April 2016.

Donald Jones, M.M., B.M., RN, CEN, and

Karen Elmore, M.S.N., RN, NE-BC. “Health-

care disasters.” West Coast University, Irvine,

Calif., April 2016.

Abdul Kamal, B.S.N., RN, Amy Weaver,

M.S.N., RN, Hlaing Thu, B.S.N., RN, and

Sonja Stutzman, Ph.D. “NREBP educational

series – dissemination of project work.” UT

Southwestern NREBP-hosted educational

series, March 2016.

Michael Levy, RN, ACNP-BC, CNRN.

“Malignant brain tumors: A look under the mi-

croscope and right way to develop a plan for

treatment.” American Association of Neurosci-

ence Nurses, New Orleans, La., April 2016.

Michael Levy, RN, ACNP-BC, CNRN.

“Special lecture: Oh the places you will go!

Acknowledging your limitless potential.”

American Association of Neuroscience

Nurses, New Orleans, La., April 2016; UT

Southwestern William P. Clements Jr. Univer-

sity Hospital, Dallas, Texas, May 2016.

Kelly Murphy, B.S.N., RN. “Day in the life

of a transplant recipient.” Texas Woman’s

University, Dallas, Texas, March 2016.

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

“Consciousness and delirium in critical care.”

Critical Care Nurses Association of the Philip-

pines Annual Convention, Manila, Philippines,

February 2016.

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

“Getting published.” American Association

of Neuroscience Nurses, New Orleans, La.,

April 2016.

Olson D, Batjer H, Zanders M, Harrison

K, and Suarez J. “Therapeutic use of music

and television in neurocritical care: A practice

survey.” Journal of Holistic Nursing, March

2016, 34(1): 6-12.

Olson D and Fishel M. “The use of auto-

mated pupillometry in critical care.” Critical

Care Nursing Clinics of North America, March

2016, 28(1): 101-107.

Olson D and Hoffman J. “Approaches to

therapeutic temperature management.”

Journal of Infusion Nursing, Jan/Feb 2016,

39(1): 26-29.

Olson D, Phillips K, and Graffagnino C.

“Toward solving the sedation-assessment

conundrum: Neurofunction monitoring.”

Critical Care Nursing Clinics of North America,

March 2016.

Olson D, Santos A, Santos G, and Stutz-

man S. “A novel approach to explore how

nursing care impacts intracranial pressure.”

American Journal of Critical Care. In press.

Omburo L, Stutzman S, Supnet C, Choate

M, and Olson D. “High variance in pupillary

examination findings among postanesthesia

care unit nurses.” Journal of PeriAnesthesia

Nursing, Sept. 2016.

Nair K. “Improving nurse competencies for

using evidence in practice.” American Journal

of Nursing (submitted).

Rogers M. “Ethical considerations in neu-

roscience nursing.” AANN Core Curriculum.

In press.

Rozo A, Olson D, Thu H, and Stutzman S.

“Situational factors associated with care-

giver burnout among emergency depart-

ment nurses.” Qualitative Health Research

(submitted).

Stephen A, Stutzman S, and Olson D.

“Creating healing uniform periods of minimum

assessment times.” Holistic Nursing Practice

(submitted).

Presentations

Posters

Publications

EPB

Nursing Growth and Professional Development 2016

820

33

39 %

New Knowledge, Innovation, and Research 51New Knowledge, Innovation, and Research50

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

“Hot is not hot.” Critical Care Nurses Asso-

ciation of the Philippines Annual Convention,

Manila, Philippines, February 2016.

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

“Interpreting the guidelines for nursing care

of the patient with large hemispheric infarct.”

International Stroke Conference, Los Angeles,

Calif., February 2016.

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

“The language of data: Results from research

on a novel method of teaching statistics.”

American Association of Neuroscience

Nurses, New Orleans, La., April 2016.

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

“Post-intensive care syndrome (PICS). Critical

Care Nurses Association of the Philippines

Annual Convention, Manila, Philippines,

February 2016.

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

“Snow White had a stroke.” Critical Care

Nurses Association of the Philippines

Annual Convention, Manila, Philippines,

February 2016.

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

“Stump the chumps: Answers to your pro-

fessional questions.” American Association

of Neuroscience Nurses, New Orleans, La.,

April 2016.

DaiWai Olson, Ph.D., RN, CCRN, FNCS,

and Stephanie Huckaby, M.S.N., RN, NEA-

BC. “Nursing research and evidence-based

practice (NREBP) educational series IV,

getting started in nursing research: Post-

er presentations, concepts, creation, and

exposition.” UT Southwestern Medical

Center Hospitals and Clinics, Dallas, Texas,

December 2016.

Poster Presentations in 2016

Linda Chan, B.S.N., RN, OCN, Tracy Mc-

Gaw, M.S.N., RN, CCRN, CNRN, and Debo-

rah Spitzer, M.S.N., RN, OCN. “Safe handling

of body fluid after hazardous drug administra-

tion: Changing policy, practice, and develop-

ing a patient/family educational brochure.” 6th

Annual Cowtown Oncology Nursing Sympo-

sium, Fort Worth, Texas, March 2016.

Linda Chan, B.S.N., RN, OCN, Tracy

McGaw, M.S.N., RN, CCRN, CNRN, and

Deborah Spitzer, M.S.N., RN, OCN. “Safe

handling of body fluid after hazardous drug

administration: Changing policy, practice,

and developing a patient/family educational

brochure.” 41st Annual Oncology Nursing

Society Annual Congress, San Antonio,

Texas, April-May 2016.

Linda Chan, B.S.N., RN, OCN, Tracy

McGaw, M.S.N., RN, CCRN, CNRN, and

Deborah Spitzer, M.S.N., RN, OCN. “Safe

handling of body fluid after hazardous drug

administration: Changing policy, practice,

and developing a patient/family educational

brochure.” UT Campus National Healthcare

Safety Week, March 2016.

April Crow, B.S.N., RN, Cynthia Hill, B.S.N.,

RN, Maureen LeDanseur, M.S.N., APRN,

ACNS-BC, Sonja Stutzman, Ph.D., and

DaiWai Olson, Ph.D., RN, CCRN, FNCS.

“Rehabilitation research and the new grad-

uate nurse.” Association of Rehabilitation

Nurses, September 2016.

Brittany Doyle, B.S.N., RN, Michael Rog-

ers, B.S., RN, DaiWai Olson, Ph.D., RN,

CCRN, FNCS, and Venkatesh Aiyagari,

M.D. “Electronic tool facilitates nurse hando-

ver and nurse-led neurocritical care rounds.”

Neurocritical Care Society 14th Annual Meet-

ing, National Harbor, Md., September 2016.

Keri Draganic, D.N.P., APRN, ACNP-BC, and

Stephanie Huckaby, M.S.N., RN, NEA-BC.

“Comparing outcomes in septic patients with

heart failure who receive the recommended or

less than the recommended IVF resuscitation

rates.” Iowa Hospitals and Clinics Evidence

Based Practice Conference, April 2016.

Jessica McNeil, M.S.N., RNC-OB, C-EFM.

“Transitioning from a nurse internship to a

nurse residency program in an academic

medical center.” Association of Women’s

Health, Obstetric and Neonatal Nurses,

Grapevine, Texas, June 2016.

DaiWai Olson, Ph.D., RN, CCRN, FNCS,

and Venkatesh Aiyagari, M.D. “Improving

hand hygiene compliance in hospital care.”

Society for Critical Care Medicine 45th Annu-

al Meeting, Orlando, Fla., February 2016.

Melissa Panter, B.S.N., RN, DaiWai Olson,

Ph.D., RN, CCRN, FNCS, Sonja Stutzman,

Ph.D., and Venkatesh Aiyagari, M.D. “Is

an algorithm for deciding picc vs. midline

IV access superior to medical experience?”

Neurocritical Care Society 14th Annual Meet-

ing, National Harbor, Md., September 2016.

Ali Saherwala, M.D., Sonja Stutzman, Ph.D.,

Junaid Kalia, M.D., Stephen Figeuroa, M.D.,

Venkatesh Aiyagari, M.D., and DaiWai Ol-

son, Ph.D., RN, CCRN, FNCS. “Exploring as-

sociations between invasive and noninvasive

blood pressure monitoring in patients receiving

vasoactive medication infusions.” Neurocritical

Care Society 14th Annual Meeting, National

Harbor, Md., September 2016.

Deborah Spitzer, M.S.N., RN, OCN, Maria

Grabowski, M.S.N., RN, OCN, Shayayegh

Rezale, M.S.N., B.S.N., RN, OCN, Catherine

Close, B.S.N., RN, OCN, Sonja Stutzman,

Ph.D., and DaiWai Olson, Ph.D., RN, CCRN,

FNCS. “Fertility preservation for cancer pa-

tients: Exploring nursing attitudes.” American

Society of Clinical Oncology, January 2016.

Deborah Spitzer, M.S.N., RN, OCN, Maria

Grabowski, M.S.N., RN, OCN, Shayayegh

Rezale, M.S.N., B.S.N., RN, OCN,

Catherine Close, B.S.N., RN, OCN, Sonja

Stutzman, Ph.D., and DaiWai Olson, Ph.D.,

Michael Rogers, B.S.N., RN, CCRN. “AMWF

research session: When is an ICP transducer

providing a value reflecting true ICP (Wait a

Tic)?” American Association of Neuroscience

Nurses, New Orleans, La., April 2016.

Linda Chan, B.S.N., RN, OCN

Neuroscience Nursing Research Center Progress 2016

90

80

70

60

50

40

30

20

10

0

Nurses Involved

Projects Started

Projects Complete

Publications and Posters

Nov 2013

Q1 2014

Q2 Q3 Q4 Q1 2015

Q2 Q3 Q4 Jan 2016

Feb Mar Apr May Jun Jul Aug Sep Oct Nov

Includes research and other projects (e.g., QI, PI, review articles).

*Complete = data collec-tion complete (research) or manuscript accepted (non-research publication)

*Projects may have more than one publication (e.g., poster and manuscript)

New Knowledge, Innovation, and Research 53New Knowledge, Innovation, and Research52

RN, CCRN, FNCS. “Fertility preservation for

cancer patients: Exploring nursing attitudes.”

6th Annual Cowtown Oncology Nursing

Symposium, Fort Worth, Texas, March 2016.

Deborah Spitzer, M.S.N., RN, OCN, Maria

Grabowski, M.S.N., RN, OCN, Shayayegh

Rezale, M.S.N., B.S.N., RN, OCN, Catherine

Close, B.S.N., RN, OCN, Sonja Stutzman,

Ph.D., and DaiWai Olson, Ph.D., RN, CCRN,

FNCS. “Fertility preservation for cancer pa-

tients: Exploring nursing attitudes.” 41st Annual

Oncology Nursing Society Annual Congress,

San Antonio, Texas, April-May 2016.

Carolyn Swann, M.B.A., RN, and Sarah

McCoy. “ABO mapping.” 2016 UNOS Trans-

plant Management Forum, Indianapolis, Ind.,

April 2016.

Jennifer Wintz, B.S.N., RN, Shelli Cherne-

sky, M.S.N., M.B.A., RN, CCRN, and James

West, B.S.N., RN. “Challenges of therapeutic

apheresis in a patient with left ventricular

assist device: Interdisciplinary collaboration

and coordination of care.” American Society

of Apheresis Annual Meeting, Palm Springs,

Calif., May 2016.

Jennifer Wintz, B.S.N., RN, Shelli

Chernesky, M.S.N., M.B.A., RN, CCRN,

Tomas Armendariz, B.S.N., RN, CMSRN,

Carol Hall, B.S.N., RN, CWOCN, CFCN,

Ravi Sarode, M.D., and Karen Matevosyn,

M.D. “Incorporation of patient’s sequen-

tial photographs in the electronic medical

records to monitor skin changes in cutane-

ous T-cell lymphoma and graph versus host

disease following extracorporeal photopher-

esis.” American Society of Apheresis Annual

Meeting, Palm Springs, Calif., May 2016.

Jennifer Wintz, B.S.N., RN, Giovanni Torti,

B.S.N., RN, Shelli Chernesky, M.S.N.,

M.B.A., RN, CCRN, Matthew Strunk, PA,

Nicole DeSimone, M.D., and Ravi Sarode,

M.D. “Intraoperative therapeutic plasma

exchange to decrease heparin-induced

thrombocytopenia (HIT) antibodies immedi-

ately prior to heart transplantation.” American

Society of Apheresis Annual Meeting, Palm

Springs, Calif., May 2016.

Fatemah Youseffi, Ph.D., RN, OCN, and

Kristen Vaught, RN. “Monthly serum HCG

(pregnancy test) during active treatment.”

41st Annual Oncology Nursing Society Annual

Congress, San Antonio, Texas, April-May 2016.

Division of Nursing – Nurse-Led Research Projects That Affect Patient Outcomes Research Comparison 2015 – 2016

Published Submitted Draft Enrolling IRB Pre-IRB

60

50

40

30

20

10

0 Jan 2016

Feb Mar Apr May Jun Jul Aug Sep Oct Nov

“I had lots of visitors during

my stay, and your staff was

amazing. The NICU nurses

were very understanding

when I had lots of visitors to

see the girls.”

In Memoriam 55In Memoriam54

In MemoriamArthur Goodley,

RN, joined

UT Southwest-

ern in Sep-

tember 2008

in the Neuro-

science ICU

and eventually

moved to the

Float Pool in

January 2015 as a Float Level 5 RN. While

in the Float Pool, Arthur spent time providing

care to patients in most nursing units across

campus, including the ICUs. Arthur was well

known and appreciated by colleagues in the

Float Pool and throughout the nursing units

across campus. The patients Arthur cared for

routinely completed PACT cards commending

his skills, and we received regular requests

that he be assigned to them as their nurse.

Because of his passion for clinical analysis

and investigation, Arthur was always first to

volunteer to staff the Clinical Research Unit.

He loved his motorcycle, was an avid dog

lover, and was very close to his family. He died

July 11, 2016.

Arthur Joseph Goodley

Patricia “Tricia”

Norman,

B.S.N., RN,

joined the staff

of UT South-

western’s

cardiovascu-

lar intensive

care unit in

March 2015.

Her passion

for and care excellence for the high-acuity

patient population quickly vaulted her to the

role of lead CVICU RN in the adult ECMO

program, a position requiring exemplary skills

in the bedside handoff of critically ill patients

to the ICU. When the UTSW transplant team

requested a group of CVICU RNs to train

for its new ex-vivo donor lung assessment

program, Tricia was one of eight unit RNs

chosen for the team by nursing leadership

and physicians based on her critical thinking

skills and ability to act independently. Her

team members considered her an inspiration

and as someone who “wanted to be part of

changes to continue to move our unit for-

ward. Tricia was who you always wanted to

be there to have your back – an exceptional

individual.” She died Dec. 15, 2016.

Patricia Dianne Norman

Gary McEntyre,

A.D.N., RN,

originally from

Paris, Texas,

was a lifelong

caregiver. After

earning his

nursing degree

at the Univer-

sity of Texas

Medical Branch at Galveston, he worked

at John Sealy Hospital in Galveston and as

a paramedic at the Huntsville Correctional

Gary Leon McEntyre Jr.

Facility before joining the staff at UT South-

western William P. Clements Jr. University

Hospital in the Emergency Department. An

Eagle Scout in his youth, Gary was known

professionally for his compassion, patience,

and poise under pressure – a temperament

perfectly suited to the ED, where quick

thinking and decisive action in the midst

of often-stressful situations is essential for

providing excellent patient care. In calmer

moments, he enjoyed preparing food for the

department whenever the opportunity arose.

He died June 1, 2016.

Nursing is a calling and a way of

life. There’s much we miss about the

colleagues we lost in 2016, but we

remember them for their dedication

to serving, helping, caring for, and

making a difference in people’s lives.

Executive Leadership56

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